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Sponsors and Collaborators: |
Duke University Eli Lilly and Company |
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Information provided by: | Duke University |
ClinicalTrials.gov Identifier: | NCT00545948 |
This study will assign subjects to either cisplatin/vinorelbine or cisplatin/pemetrexed chemotherapy using a genomic based expression profile to determine chemotherapy sensitivity in completely resected early stage non-small-cell lung cancer (NSCLC). Once patient eligibility is determined, the genomic expression profile will be done on fresh frozen tumor resected at the time of surgery. Two-year progression free survival was chosen as an endpoint in order to assess the effectiveness of directed adjuvant chemotherapy regimens in a population of patients receiving platinum based chemotherapy for early stage NSCLC.
Condition | Intervention | Phase |
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Carcinoma, Non-Small-Cell Lung |
Drug: Vinorelbine followed by Cisplatin Drug: Pemetrexed followed by Cisplatin |
Phase II |
Study Type: | Interventional |
Study Design: | Treatment, Non-Randomized, Open Label, Uncontrolled, Parallel Assignment, Efficacy Study |
Official Title: | Phase II Prospective Study Evaluating the Role of Directed Cisplatin Based Chemo With Either Vinorelbine or Pemetrexed for the Adj Tx of Early Stage NSCLC in Patients Using Genomic Expression Profiles of Chemo Sensitivity to Guide Therapy |
Estimated Enrollment: | 117 |
Study Start Date: | October 2007 |
Estimated Study Completion Date: | October 2010 |
Estimated Primary Completion Date: | March 2010 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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Arm A-Vinorelbine
Resected tumor will be used for genomic expression profiling. Patients with a genomic expression pattern suggestive of vinorelbine sensitivity will be given cisplatin + vinorelbine.
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Drug: Vinorelbine followed by Cisplatin
Vinorelbine 25 mg/m2 IV over 6-10 minutes days 1 and 8, followed by Cisplatin 75 mg/m2 IV over 60 minutes on Day 1 (every 21 days x 4 cycles).
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Arm B-Pemetrexed
Resected tumor will be used for genomic expression profiling. Patients with a genomic expression pattern suggestive of pemetrexed sensitivity will be given cisplatin + pemetrexed.
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Drug: Pemetrexed followed by Cisplatin
Pemetrexed 500 mg/m2 IV infusion over approximately 10 minutes on day 1, followed by Cisplatin 75 mg/m2 IV over 60 min on Day 1 (every 21 days x 4 cycles)
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The proposed study is a multi-center open label phase II study of the chemotherapy doublets cisplatin/vinorelbine and cisplatin/pemetrexed as adjuvant therapy in early stage NSCLC.
Eligible patients will have no previous treatment for the current diagnosis of NSCLC. The two treatment groups of patients will be determined by gene expression profile analysis of each patient's tumor: one group of vinorelbine-sensitive patients and one group of pemetrexed-sensitive patients. The genomic expression profiling that will be utilized generates a percentage for likelihood of chemotherapy sensitivity. Patients will be directed to receive the chemotherapy regimen for which the percentage of predicted sensitivity is highest. For instance, if the model predicted the likelihood of tumor sensitivity was 46% to cisplatin/vinorelbine and 48% to cisplatin/pemetrexed, then the adjuvant chemotherapy would be directed to cisplatin/pemetrexed. Patients whose tumors cannot be adequately analyzed for gene expression will be offered adjuvant therapy off protocol as deemed appropriate by their primary oncologist.
One hundred and seventeen patients with stage IB (> 4 cm), II or IIIA NSCLC will be enrolled. The vinorelbine-sensitive tumors group will receive Vinorelbine 25 mg/m2 days 1 and 8, followed by cisplatin 75 mg/m2 day 1, every 21 days for 4 cycles. The pemetrexed-sensitive tumors group will receive pemetrexed 500 mg/m2 on day 1 followed by cisplatin 75 mg/m2 day 1, every 21 days for 4 cycles. Standard pre-medication regimens will include dexamethasone, vitamin B12 and folate supplementation in the pemetrexed group. Patients in both groups will receive up to a maximum of 4 cycles of therapy.
A pilot study is appropriate in this case because currently there is not a defined clinical role for genomics technology in determining therapy for NSCLC. The two chemotherapy regimens provided to the study patients are active agents in the treatment of NSCLC. Study treatment will consist of 4 cycles of chemotherapy.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patients are eligible to be included in the study only if they meet all of the following criteria:
Required laboratory data within one week of enrollment:
Exclusion Criteria:
Patients will be excluded from the study if they meet any of the following criteria:
Contact: Debra M Shoemaker, RN | 919-668-6498 | shoem002@mc.duke.edu |
Contact: Toni Bjurstrom, RN | 919-668-6495 | bjurs002@mc.duke.edu |
United States, North Carolina | |
Duke University Medical Center | Recruiting |
Durham, North Carolina, United States, 27710 | |
Contact: Neal Ready, Ph.D., M.D. 919-681-6932 neal.ready@duke.edu | |
Principal Investigator: Neal Ready, Ph.D., M.D. | |
Sub-Investigator: Anil Potti, M.D. | |
Sub-Investigator: Thomas D'Amico, M.D. | |
Sub-Investigator: Joseph Nevins, Ph.D. | |
Sub-Investigator: Michael Datto, M.D., Ph.D. | |
Sub-Investigator: Michael Kelley, M.D. | |
Duke Raleigh Hospital | Recruiting |
Raleigh, North Carolina, United States, 27609 | |
Contact: Lynda Owens, PhD 919-419-4631 lynda.owens@duke.edu | |
Contact: Melanie Watson, MSN, ANP-C 919-419-5010 melanie.watson@duke.edu | |
Sub-Investigator: Michael Spiritos, MD | |
Sub-Investigator: Linda Sutton, MD | |
Sub-Investigator: Gina Vaccaro, MD | |
Sub-Investigator: Yuri Fesko, MD | |
Sub-Investigator: Sharon Taylor, MD | |
Presbyterian HealthCare | Recruiting |
Charlotte, North Carolina, United States, 28204 | |
Contact: Lien Ngo, BS, MT 704-384-5925 ltngo@novanthealth.org | |
Principal Investigator: Richard B Reiling, MD, FACS |
Principal Investigator: | Neal Ready, Ph.D., M.D. | Duke University Medical Center, Hematology/Oncology, Duke Comprehensive Cancer Center |
Responsible Party: | Duke University Medical Center, Duke Comprehensive Cancer Center ( Neal Ready, Ph.D., M.D. ) |
Study ID Numbers: | Pro00000657 |
Study First Received: | October 16, 2007 |
Last Updated: | February 23, 2009 |
ClinicalTrials.gov Identifier: | NCT00545948 History of Changes |
Health Authority: | United States: Institutional Review Board |
Non-small-cell lung cancer NSCLC Genomics Guided Therapy |
Directed Therapy Genomic Expression Profiles Chemotherapy Sensitivity |
Antimetabolites Thoracic Neoplasms Adjuvants, Immunologic Folic Acid Antagonists Carcinoma Folic Acid Pemetrexed Vinorelbine Respiratory Tract Diseases |
Cisplatin Radiation-Sensitizing Agents Lung Neoplasms Lung Diseases Non-small Cell Lung Cancer Antineoplastic Agents, Phytogenic Carcinoma, Non-Small-Cell Lung Neoplasms, Glandular and Epithelial |
Thoracic Neoplasms Antimetabolites Antimetabolites, Antineoplastic Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Physiological Effects of Drugs Neoplasms by Site Respiratory Tract Diseases Cisplatin Lung Neoplasms Therapeutic Uses Respiratory Tract Neoplasms Neoplasms by Histologic Type |
Enzyme Inhibitors Folic Acid Antagonists Pharmacologic Actions Carcinoma Pemetrexed Neoplasms Vinorelbine Radiation-Sensitizing Agents Lung Diseases Carcinoma, Non-Small-Cell Lung Antineoplastic Agents, Phytogenic Neoplasms, Glandular and Epithelial |